Negative longitudinal magnetoresistance (NLMR) is shown to occur in topological materials in the extreme quantum limit, when a magnetic field is applied parallel to the excitation current. We perform pulsed and DC field measurements on Pb1-xSnxSe epilayers where the topological state can be chemically tuned. The NLMR is observed in the topological state, but is suppressed and becomes positive when the system becomes trivial. In a topological material, the lowest N=0 conduction Landau level disperses down in energy as a function of increasing magnetic field, while the N=0 valence Landau level disperses upwards. This anomalous behavior is shown to be responsible for the observed NLMR. Our work provides an explanation of the outstanding question of NLMR in topological insulators and establishes this effect as a possible hallmark of bulk conduction in topological matter.